Honey I'm home...

A friend called from a well known relatively malignant east coast program, crying. She says she has cried twice during her month on the wards, feels she knows nothing, that she is going too slow and wishes she had studied more during her fourth year. This girl was very much a go-getter during all of medical school, studied plenty and is definitely as smart as her peers at this program. She has been on her own a lot, getting that autonomy these programs tout, but also been expected to know things she has never learned about. Ah, the life of an intern.

I'll admit, I have cried too. The last time was just two days ago when I lost a patient I had been caring for for a couple of weeks. She had been sick for at least 6 weeks before she came in. She was one of my most complicated patients but she was talking to us, and I hoped we could "fix" her and get her back to her regularly scheduled life. Apparently I was the only one on the team with such hope and I was actually informed by the ophthalmologist that we consulted (before he saw the patient) that he had never known anyone to survive what she had. I kind of scoffed. Really? (That is not what up-to-date says.) Apparently there is no substitute for experience. Of course, at the same time she was dying I had to be in clinic. My senior resident had the day off and luckily he had incredible backup who helped.

Then one of my other patients started seizing (apparently dilantin is not the drug for her - though can she afford Keppra??). I spent 4.5 hours with one patient in clinic due to the inefficiency of the clinic and the fact that the patient needed psychiatry followup which apparently takes 4 hours to get.

A bunch of other stuff also went wrong (including my first bone marrow in front of the attending) and I ended up staying at the hospital until 7:30pm, planning to come back on my "day off." The last two things I did that day were sit with an oncologist telling my patient's family about the treatment for metastatic melanoma to the brain and sitting with my other patient's family just after my other patient had passed.

My senior resident told me to go home, that he would fix anything remaining in the morning. At that point everybody was stable, but I pretty much felt like a complete failure. And to be honest, after reflecting this weekend on it all, I just know I have a lot to learn.

To me friend at her crazy east coast program: you can't be in two places at one time. Do your best. Ask for backup if you think you need it. I am glad the seniors here don't make us feel like wimps for doing that.

I won't have another day off for at least the next 12 days. So... I am not going in today. I'll start early tomorrow and straighten out the rest. Then I'll admit five new patients. At least I get to start fresh with them.

As for my family - we are having a great weekend together. Cooking, shopping, swimming, playing, relaxing. I got my first paycheck. We closed on our condo Thursday. I am so glad I have a family at home to diffuse my stress. Nothing like a happy, smiling, belly-laughing 7 month old to make you realize it is all going to be ok.